MANAGEMENT OF THE SICK YOUNG INFANT AGED UP TO 2 MONTHS
Name:
Age:
Weight:
Length(cm):
Ask: Follow-up Visit?
1. What are the child's problems?
2. Initial Visit?
3. Follow-up Visit?
ASSESS (Circle all signs present)
Classify
CHECK FOR SEVERE DISEASE AND LOCAL BACTERIAL INFECTION
Is the infant having difficulty in feeding?
Has the infant had convulsions?
● Count the breaths in one minute. ___ breaths per
minute
● Repeat if elevated: ___ Fast breathing?
● Look for severe chest indrawing.
● Look and listen for grunting.
● Look at the umbiculus. Is it red or draining pus?
● Fever(temperature 38°Cor above fells hot) or low body
temperature(below 35.5°C
● Look for skin pustules. Are there many or severe
pustules?
● Movement only when stimulated or no movement
even when
● stimulated?
THEN CHECK FOR JAUNDICE
●
When did the jaundice appear first?
DOES THE YOUNG INFANT HAVE
DIARRHOEA?
● Look for jaundice (yellow eyes or skin)
● Look at the young infant's palms and soles. Are they
yellow?
●
●
●
●
Look at the young infant's general condition. Does
the infant:
o move only when stimulated?
o not move even when stimulated?
Is the infant restless and irritable?
Look for sunken eyes.
Pinch the skin of the abdomen. Does it go back:
o Very slowly?
o Slowly?
THEN CHECK FOR FEEDING PROBLEM OR LOW WEIGHT
If the infant has no indication to refer urgently to
hospital
● Is there any difficulty feeding? Yes ___ No ___
● Is the infant breastfed? Yes ___ No ___
● If yes, how many times in 24 hours? ___ times
● Does the infant usually receive any other foods or
● drinks? Yes ___ No ___
● If yes, how often?
● What do you use to feed the child?
CHECK FOR HIV INFECTION
●
●
Determine weight for age. Low ___ Not low ___
Look for ulcers or white patches in the mouth
(thrush).
● Note mother's and/or child's HIV status:
o
Mother's HIV test: NEGATIVE POSITIVE NOT DONE/KNOWN
o
Child's virological test: NEGATIVE POSITIVE NOT DONE
o
Child's serological test: NEGATIVE POSITIVE NOT DONE
● If mother is HIV positive and and NO positive virological test in young infant:
Yes:____ No:____
o
o
o
Is the infant breastfeeding now?
Was the infant breastfeeding at the time of test or 6 weeks before it?
If breastfeeding: Is the mother and infant on ARV prophylaxis?
ASSESS BREASTFEEDING
● Has the infant breastfed in the previous hour?
If the infant has not fed in the previous hour, ask the
mother to put her
infant to the breast. Observe the breastfeed for 4 minutes.
● Is the infant able to attach? To check attachment, look
for:
o
Chin touching breast: Yes ___ No ___
o
Mouth wide open: Yes ___ No ___
o
Lower lip turned outward: Yes ___ No ___
o
More areola above than below the mouth: Yes
___ No ___
o
not well attached good attachment
● Is the infant sucking effectively (that is, slow deep
sucks, sometimes
pausing)?
o
not sucking effectively
o
sucking effectively
CHECK THE CHILD'S IMMUNIZATION STATUS (Circle immunizations needed today)
BCG
OPV-0
DPT+HIB1
OPV-1
DPT+HIB2
OPV-2
ASSESS OTHER PROBLEMS:
Hep B 1
Hep B 2
Ask about mother's own health
200,000 I.U
vitamin A to
mother
Return for next
immunization on:
________________
(Date)
Treat
Return for follow-up in ... days. Advise mother when to return immediately. Give any immunization and feeding advice needed today.